Patients' satisfaction with immediate breast reconstruction with a latissimus dorsi musculocutaneous flap

Abstract

Immediate breast reconstruction with a latissimus dorsi musculocutaneous (LDM) flap is still not much reported, particularly in studies of patients' views. The aim of this study was to assess the level of patients' satisfaction with the technique. All patients (n = 257) who had had a mastectomy and immediate breast reconstruction with a LDM flap at a single hospital between January 1999 and December 2005 were identified, and 196 patients free of recurrence were included. The operations were done by the same surgical team in a standard manner. Clinical data, technical details, and outcome were collected prospectively. To assess the patients' degree of satisfaction with the aesthetic results in relation to clinical characteristics and treatment, a study-specific questionnaire and a visual analogue scale were sent to 196 patients; 178 forms were completed and returned. To analyse general satisfaction and aesthetic results we used the Mann-Whitney, Kruskal-Wallis, chi square, or Fisher's exact test, as appropriate. The median reconstruction follow-up period was 34 months. Patients who were 51 years or older at the time of reconstruction were less likely to opt for immediate breast reconstruction with LDM flap than younger patients. Patients who were divorced and those who had postoperative complications were less likely to be satisfied. One hundred and sixty-four patients (92%) were satisfied, and 161 (90%) said they would recommend the reconstruction. The median satisfaction score was 9 (range 1-10, mean 8.5). The technique provided satisfactory immediate breast reconstruction according to the patients' evaluation.

Langzeitresultate nach chirurgischer Behandlung von Brustasymmetrien aus Sicht der Patientinnen: Eine Analyse von 51 Fällen

“…Es wurde stattdessen eine visuelle analoge Skala (VAS) verwendet. Das sehr weit verbreitete Instrument der VAS zur Messung der Patientenbeurteilung ist ideal, um auf kurze, klare Fragestellungen intuitiv zu antworten und wurde schon mehrmals für die subjektive postoperative Beurteilung nach Brusteingriffen verwendet[7][8][9]. Syndrom oder Becker Nävus Syndrom, welches sehr selten auftritt und auch mit Brusthypoplasie einhergehen kann…”

‘It's a silver lining’: A template analysis of satisfaction and quality of life following post‐mastectomy breast reconstruction

“…However, other women described declining appearance satisfaction over time, due to either ptotic nature of autologous‐based reconstruction or the fuller projected breast implant‐based reconstruction affords. Previous research demonstrates the failure of implant‐based reconstruction to naturally ptosis as the patient ages as an area of dissatisfaction (Dutra et al ., ). However, declining satisfaction due to the ptotic nature of autologous‐based reconstruction is a unique finding to this study.…”

“…It is highly debated which type of reconstructive technique is the most appropriate within the field of plastic and reconstructive surgery (Dutra et al ., ). This is problematic as patients are often presented with more than one viable surgical option.…”

Evolving options for breast reconstruction

“…Overall, patients are highly satisfied with their outcome following these procedures. 75,78 Summary In summary, the TRAM flap should be rotated so that zone 3 tissue is in the superior position at inset. Bilateral TRAM flaps result in minimal hernia rates with proper donor site closure.…”